Individual provider Active NPI

Larry Lee Lausch Jr., D.C.

  • Chiropractor
  • Ephrata, PA
National Provider Identifier
1629031364
Registry record updated Apr 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC005653L Issued in PA
Practice address
11 Long Ave
Ephrata, PA 17522-9795
Phone
(717) 733-6886
Fax
(717) 733-6996
NPI assigned
Apr 11, 2006
Last updated
Apr 14, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC005653L PA Primary

Addresses

Primary practice location

11 Long Ave
Ephrata, PA 17522-9795

Mailing address

11 Long Ave
Ephrata, PA 17522-9795
Phone (717) 733-6886

Other identifiers 4

IdentifierTypeStateIssuer
50000860OtherPACAPITAL BLUE CROSS
P00082236OtherRAILROAD
4674663OtherPAAETNA
1338500OtherPAHIGHMARK BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111208000265 PA Practitioner - Chiropractic 0143115261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proactive Pain Relief and Wellness, PCGroup PAC ID 9436044542, 2 clinicians

Practice addresses (Care Compare)

4 Muddy Creek Church Rd
Denver, PA 17517-9357
Phone (717) 733-6866

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Pain Relief & Wellness, PC Chiropractor CurrentSince Oct 20, 2001 Accepting new patients

Locations

11 Long Ave
Ephrata, PA 17522
Phone (717) 733-6866

916 N Reading Rd
Ephrata, PA 17522
Phone (717) 336-8110

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208131200000",
    "number": "1629031364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 LONG AVE",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175229795",
            "telephone_number": "717-733-6886",
            "fax_number": "717-733-6996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 LONG AVE",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175229795",
            "telephone_number": "717-733-6886",
            "fax_number": "717-733-6996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUSCH",
        "first_name": "LARRY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2008-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC005653L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50000860",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00082236",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4674663",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1338500",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ephrata, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.